If abortion saves lives ... what's happening in Chile?

Published in the National Post

May 14, 2012
| by Andrea Mrozek

Abortion rights activists repeatedly tell Canadians that without legal abortion, women die. Recently, Carolyn Egan of the Ontario Coalition for Abortion repeated this mantra in discussing Stephen Woodworth's non-binding motion proposing a bi-partisan committee to discuss when life begins. Ms. Egan took the benign proposal to be the first step toward outlawing abortion, and said: "[W]e know if it is outlawed, we are going to go back to a situation where women will die from illegal abortions. Anywhere in the world where there are illegal abortions you see the death rates just go up and up and up."

If that's the case, what's happening in Chile?

A peer-reviewed study published last week examines 50 years of data and concludes that the trajectory of maternal mortality in the South American country has consistently declined, decreasing from 293.7 in 1957 to 18.2 in 2007 (per 100,000 live births). That's a decrease of 93.8%, which constitutes a major success story measured in women's lives.

Yet Chile outlawed abortion in 1989.

Chile didn't just place small restrictions on abortion - it outlawed abortion without exception, including in instances of rape or for the health of the mother. And since many neighbouring countries also restrict abortion, there's no real reason to believe Chilean women are travelling outside Chile to get abortions.

Even so, maternal mortality continued to decline after the abortion ban, including deaths related to abortion.

This is troublesome for the abortion-rights movement, which back in 2010 said that Canada's maternal health mandate in the developing world must include abortion because abortion saves lives.

They cited World Health Organization statistics to bolster their claims. However, by the WHO's own admission, these numbers are estimates. Elard Koch, lead author of the Chilean study, says theirs is the first comprehensive study of its kind, relying not on projections or assumptions, but data. He writes:

"The Chilean study is the first in-depth analysis of a large time series, year by year, of maternal deaths and their determinants, including years of education, per capita income, total fertility rate, birth order, clean water supply, sanitation and childbirth delivery by skilled attendants, and including simultaneously different historical policies."

Chile is not the only country that restricts abortion and has low maternal mortality. According to data from a Lancet study published in 2010, Poland, El Salvador and Nicaragua also show a similar trend line: Decreasing maternal mortality in spite of abortion being made illegal. Malta and Ireland too have laws restricting abortion and low maternal mortality.

In fact, right here in Canada, our very own maternal mortality rate was on the decline in the 1930s, well before abortion became available on demand in 1988 with the Morgentaler decision.

The truth is that it is better health care, not abortion, that substantially improves maternal mortality rates - access to skilled birth attendants and access to maternal health-care services. Higher education levels for women also serve to decrease maternal mortality.

In light of these findings, abortion rights activists should stop making sweeping predictions that restricting abortion will result in skyrocketing maternal deaths and stop insisting that abortion is the key to improving women's health. The data simply don't back up such claims.